After suffering from headaches all her life, Emily Guzan was diagnosed with chronic migraine four years ago. She has since left her law career to help people living with migraines and other pain conditions. In these recent excerpts from her blog, That M Word, she describes what everyday life is like for a migraine sufferer...

Living With Migraines: The First TimeI’ve had headaches ever since I was a little kid, but I vividly remember my first migraine. I was in college, watching the Pittsburgh Steelers play in the Super Bowl. A few friends and I watched it at a fraternity house. Our “dinner” that night was typical college fare: pizza and beer. As soon as the Steelers won, all of us went running to lower campus to celebrate with the rest of our friends.

When we got there, we found students rioting, jumping on cars and setting things on fire. I wanted absolutely nothing to do with it, so I went back to my sorority suite to go to bed. I also noticed my head was hurting, but I was used to having headaches.

My sorority suite was in a residence hall located smack in the middle of all the riots. The noise outside seemed to aggravate my head even further. Suddenly I started to feel nauseous.

Normally, I would sleep off a headache, but the pain was so intense, I was unable to fall asleep. Eventually with time, water and some over-the-counter medicine, my pain went away.

It wasn’t until almost a year and a half later, when my migraines got really bad in law school, that I realized what I had experienced during Super Bowl 2006 was a migraine.

Jan. 31, 2012Living With Migraines: Insensitive PeopleIn August, I went to the ER with a particularly severe migraine and had to return the next day because the intravenous medicine (dilaudid for pain and Zofran for nausea) didn’t work.

My ER doctor wasn’t sympathetic to migraines and suggested I must just have an anxiety problem. She gave me a cocktail of intravenous medications (Toradol, a non-narcotic pain reliever, Reglan for nausea and Benadryl) to which I had a severe allergic reaction. I was unable to move my limbs or speak and required an oxygen tank for a [while]. I had to take a week off work just to garner the strength to walk from my bed to the door on my own.

Ultimately, I decided to leave my job at a law firm, partially because of migraines and the hospitalization. Subsequently, an associate told some co-workers she didn’t see the big deal over “a couple of headaches” and figured I “just couldn’t handle the stress.”

Why are we so insensitive to each other? More specifically, why are people so insensitive to people with disabilities or conditions different from their own? What can we do about it?

April 25, 2012Living With Migraines: 24 HoursA day as a migraineur, as told to my migraine diary...

10 p.m.: Head suddenly starts to feel tender. Probably just a headache, not a migraine. Planning to “sleep it off.” Can’t afford to waste 1 of the 4 sumatriptan pills my insurance provides per month on an insignificant headache. [Triptan medications such as sumatriptan constrict blood vessels in the head and may block pain signals. Different insurance plans impose different coverage limits for these drugs.]

3 a.m.: Awoken by the pain. Really throbbing now. Should have taken the meds. Maybe some NSAIDs [over-the-counter pain relievers such as ibuprofen] will do the trick.

7 a.m.: Time to get up. Pain is much more intense. NSAID pills were useless. Time for sumatriptan pill. Need to remember that all headaches turn into migraines.

12 p.m.: Called in sick for work. Can’t even do half day. Don’t want to use another sumatriptan pill. Can’t get out of bed without feeling nauseous. Vision in right eye is completely blurred.

6 p.m.: What a waste of a day. Time to try a sumatriptan injection. $400 a pop, can’t waste them. Trembling too much to self-inject, so boyfriend came over to help. Hoping this works.

10 p.m.: Starting to feel some relief. Must be what it feels like to get hit by a train. Have to figure out a way to catch up on two nights [of lost] sleep and recover in time for work tomorrow.

April 27, 2012Living With Migraines: The 5 Best and Worst Parts of Being a MigraineurThese are the 5 hardest parts of living with migraines:

1. A life of prevention: Constantly in fear of the next migraine, we carry pills with us everywhere (abortive medications, such as triptans and midrin, which work in the brain to stop the migraine process) and heed our doctor’s instructions. Leaving my house requires me to prepare as though I’m packing for a weekend trip with a toddler (medication, water, approved snacks such as apples, berries and raw almonds).

2. Lack of understanding/empathy from others: See “Insensitive People,” above.

3. Cost of medical bills: Most insurers refuse to cover us because migraines are a “preexisting condition.” My injections [of sumatriptan] cost around $400, and an average ER visit is around $650.

4. Restrictions that other people don’t have: For me this means leaving a career, following pill schedules, keeping to a strict daily exercise regimen (but not overexercising), giving up known migraine triggers such as caffeine and alcohol, and strict low-tyramine dietary changes. [Tyramine, a natural amino acid in certain foods – including fermented or aged products as well as peanuts and bananas – can sometimes trigger migraines by constricting and then dilating blood vessels in the head, according to the National Headache Foundation.]

5. Being unreliable: I’m hesitant to make plans and constantly canceling on people.

These 5 small victories help keep migraineurs going:

1. Migraine-free days!

2 Support from the virtual migraine community: Joining Twitter and other sites has really boosted my mood and made me feel less alone.

3. When people DO understand: My co-workers show their respect for my condition and me by not bringing fish for lunch, for example, since the smell is a huge migraine trigger for me.

4. Doing things I never thought I could do: Whether it’s maintaining a blog, pushing myself in a yoga pose or completing a running plan, I try to use the momentum from these little things to keep a positive outlook.

5. Finally finding what works for you: Eating vegan, drinking plenty of water, giving up caffeine and alcohol, regular exercise and yoga and keeping stress to a minimum have been huge for me. There’s no cure for migraine, but there are ways to have more good days than bad.

June 3, 2012Living With Migraines: My Worst Migraine TriggersMy two biggest and most unavoidable triggers are weather and hormonal changes.

I’ve written about the first one a lot: According to the Mayo Clinic, weather-related changes may cause an imbalance in brain chemicals, including serotonin, which can either cause a migraine or make one worse.

As to the second, I’m taking daily medication to help with it the best that I can. (I’ve used different preventive medications, including Topamax, an anti-seizure drug, and Effexor, an antidepressant. Now I’m taking YAZ, a birth-control pill, to help me determine through hormone regulation when my migraines might be coming.)

There’s not much I can do about either of them but try to stay hydrated, exercise regularly and keep a healthy diet.

However, the migraine trigger that probably annoys me the most is a weird one: stinky food odors. I’m talking about really strong, pungent odors. I can’t eat in restaurants that smell too much like fish or strong spices.

June 5, 2012Living With Migraines: What’s The Biggest Myth?If I could tell non-migraineurs one thing about migraines, it would be this:

There is no “cure” for migraines.

Non-migraineurs often, out of kindness, ask why my doctors haven’t found a cure yet. Or they might suggest any variety of remedies: Botox, acupuncture, eating apples or cherries, implanting a device in your ear, to name a few.

Some migraineurs have found certain methods of prevention work for them, such as making dietary or medication changes. Some find relief during a migraine attack through medications or holistic remedies. There is no end-all, be-all means of prevention or relief, and there’s certainly not one thing that works for everyone.

June 13, 2012Living With Migraines: Accomplishments in Spite of ThemAs a migraineur, I sometimes tend to focus on the negative aspects of migraine disease, but it’s great to take the opportunity to reflect on and celebrate all accomplishments, no matter how minor.

I was diagnosed with migraine in 2008. Since then, I accomplished the following:

Graduated law school

Found a wonderful, supportive boyfriend

Studied for and passed the bar

Rented my own apartment

Learned new hobbies like cooking and photography

Adopted a kitten

Ran a 5K

Started changing my career path to pursue what I really enjoy

Taken control of my health

Reviewing this list makes me so happy. I didn’t focus on the negative: For example, I didn’t focus on how many ER visits it took for me to pass law school and the bar. I didn’t mention that I had to leave my job primarily due to migraines. I didn’t mention that I couldn’t even get past the first day of a part-time job because of a migraine. I didn’t get into my insurance battles.

Try to focus on the positive. That’s a great lesson for us all.

June 15, 2012Living With Migraines: Prevention at the BeachI’m so excited to be taking a road trip to the beach this weekend! I’ll be going with my boyfriend’s family, and this is my first vacation with them even though we’ve been dating a long time.

Everyone is staying together, and this is my first vacation staying with multiple people in a house. So I have to take extra steps to ensure my migraine prevention needs are met:

Sleep: I’ll be on a pull-out sofa bed, and I’d be lying if I said I wasn’t concerned about this. If I don’t get a good, full night of sleep, I’ll get a migraine. If I need to lie down during the day and can’t, I’ll get a migraine.

Eating: Migraineurs have to eat regularly because hunger is such a huge trigger. Additionally, following a low-tyramine vegan lifestyle, I can’t eat junk or frozen food, and I need to get fresh produce, soy products and whole grains.

Sun: Last Saturday, driving in the sun for just an hour knocked me out for the entire day. My boyfriend, on the other hand, could lie in the sun at the beach all day and be ready to go out at night. I need to be mindful of my sun exposure and make sure I limit it as much as possible.

Smells: With everyone in one house, I’m hoping that the food odors and fragrances are at a minimum. Hopefully, the weather will be pleasant enough so that we can keep the doors and windows open to let fresh air in.

My biggest concern is that I’m going to seem like a “high-maintenance” person.

Update: The trip was a success for the most part. On the first night, I got a migraine and was unable to spend time with everyone. I laid in a dark, quiet room and took a sumatriptan pill. The migraine didn’t go away until the afternoon of the second day, but luckily it didn’t come back for the rest of the trip.

My boyfriend's family was very supportive of my needs, and completely understanding when I needed to change dinner plans one night to meet my migraine diet. And after having only one migraine in six days of vacation, I can't complain!

July 3, 2012Living With Migraines: Summer HeatOne migraine trigger that I’m really learning more about this summer is heat. I’m very aware that cold weather is a big trigger for me. But since we’re having an unusually hot summer this year, I’m learning that extreme heat and sun exposure likewise have negative effects.

Not surprisingly, the constant transition between air conditioning and outdoor heat also triggers migraines for me.

This summer, I’ve had to miss days at the beach, cookouts and other activities because of the high (over-90-degree) temperatures. The hardest part is trying to explain to friends and family why I can’t attend something. Often, I’ll back out if I can tell, given a number of factors, including temperature, that it will be a “migraine day.”

I’m trying to get better at taking my triptan medicine when I think a migraine is coming, and, luckily, I haven’t needed any more serious medication so far this summer. Being more aware of my triggers and being upfront with others about how I’m feeling has helped me so far.

July 10, 2012Living With Migraines: “Every migraine is like a snowflake.”My boyfriend said this a few weeks ago, and it completely helped me understand the non-migraineur perspective.

For example, sometimes I feel a migraine starting, and one sumatriptan helps it go away immediately. Other times, I feel a migraine starting and it increases in pain and severity so rapidly that taking a sumatriptan completely incapacitates me. (Typically after I take it, the headache stage of the migraine attack gets worse before it gets better; and even after it works, I have to lie down or sleep.)

When he said this, it really helped me understand the confusion that our family and friends might be facing in their attempt to help us deal with our disease. It must be frustrating for our loved ones to try to help, but have no idea the extent of our pain on any given migraine day.

July 13, 2012Living With Migraines: Make a Survival Kit!If you’re like me, you have to run through a checklist of everything you’re taking with you before you leave the house: keys, wallet, cell phone, etc. Migraineurs have to have a few extra things on hand at all times in case of a migraine attack. A few days ago, I decided to gather these into a convenient grab-and-go package.

My essentials:

Medicine: The key to migraine relief in many cases is taking abortive medicine early, at the first sign of pain.

Water bottle: Dehydration is a huge migraine trigger for me. I carry a water bottle everywhere: work, church and errands included!

Lip balm (fragrance-free): The confusion associated with migraine sometimes affects me in ways similar to OCD [obsessive compulsive disorder]. For me, this manifests itself in the form of extreme frustration with chapped lips (and clutter, among other things).

Sunglasses: When I’m in the throes of a migraine attack, I need to keep out as much light as possible, even if it means wearing sunglasses indoors.

Migraine diary: I keep mine on my phone, but it’s important for me to write down my triggers, keep track of the length of my migraine attack and note the medications I tried for each particular attack. In case I need to call the doctor or visit the ER, this information is important to convey to medical professionals.

How Much Do You Know About Migraine Headaches?In the U.S. alone, 30 million people suffer from migraine headaches, and the condition is three times more common in women than in men. However, surveys show that fewer than half of sufferers have received a diagnosis from their health-care providers. Do you or someone you know get migraine headaches? Test your knowledge with our migraine quiz.

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